Why this week makes me glad I am a doctor

 

This week I head into the wild to serve as camp doctor for a children’s summer camp. It’s a special week for many reasons.

Here’s what happened last summer.

 

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For one week I was the doctor at an exclusive summer camp for children ages 7 through 11 years. Only a few children are accepted to this camp from those who qualify. There are strict requirements for admission, but once a child qualifies, they can return every year until they reach 11. Both boys and girls are recruited to attend.

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So exclusive is this camp that the ratio of staff to children is almost one to one. Some activities are done in large groups; others are done in groups of four campers with at least 2 adults.  There were adult staff in charge of leading music, teaching crafts, hiking, fishing, swimming and drama presentations. Additional staff came each evening for special programs and a birthday party for everyone. Since we were there the week of Independence Day, there was a fireworks show one evening.

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Three hot meals, served all-you-can-eat style, and snacks were provided daily. Assisted by a registered nurse, I oversaw treatment of any injuries, assessed illness and dispensed medications. The campers slept in air-conditioned cabins with full bath facilities, supervised by adult staff.

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The total cost of running this 5 day camp is in the tens of thousands of dollars; the cost to each child’s family-nothing.

Sound wonderful to you? The kind of camp you would like to send your child or grandchild to? No, it isn’t.

 

This camp is exclusive but you can’t buy your way into this camp. It is not for the children of the rich and famous, celebrities, entertainers, politicians, or doctors.

 

This camp is reserved for children who are in the foster care system- children who have been abused, neglected and/or abandoned by their parents.

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By  sponsoring these camps Royal Family Kids has been

confronting abuse and changing lives since 1990 .

The camps are staffed by local people for children in their community, usually affiliated with a church. All are volunteers. Funds to pay for the camp are raised by individual and corporate donations, grants, and old fashioned fund raisers like pie auctions .

Child abuse is a preventable, treatable medical condition- and a crime.

The American Academy of Pediatrics calls it  “a public health problem with lifelong health consequences for survivors.”

The World Health Organization calls it a “global priority” due to its potential impact on social and economic development.

All organizations that deal with child abuse agree that prevention is much more effective than treating the effects of abuse.

Child abuse is underrecognized and underreported but estimates are that as few as 4% to as many as 30% of children worldwide experience some sort of maltreatment- physical injury, emotional abuse, neglect, sexual assault or exploitation.

Many of these children land  in the foster care system which can be another form of abuse. Foster children may be shuffled from one home to another without warning, separated from siblings, leaving behind  personal possessions like  clothes, toys, books and photos. They have few opportunities to do normal kid activities like summer camps, family vacations, play sports and music lessons.

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That is why our camp is so important. For their week at camp, each child gets  caring attention from safe adults, many of whom return year after year. The goal of the camp is to create positive memories for kids who have few. Each craft is carefully packed to go back with the child, as is a small photo album filled with pictures of their activities at camp.

 

For the sake of their privacy and protection, I cannot show pictures of the children to you, but these photos  from the camp give you an idea of the fun things they did that week. Most important, they are taught that their life has value and that they can overcome the challenging situation that has brought them here. 

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If you suspect a child is being abused, here is how you can help.

State child abuse reporting phone numbers

Life, Liberty, and the Pursuit of Health Care

update January 1, 2026

Since writing this post almost 10 years ago, I have done several updates and related posts. I recommend you read this more recent version and the one that follows. Keep exploring the Heart of health.

from 1776 to 2020-a vision for a “more perfect Union”

The United States’ healthcare system combines public health efforts with mostly private delivery of health care. Usually they coexist side by side with some but infrequent interaction. The public health emergency created by the pandemic forced them into a “union” that quickly became politicized, and unfortunately diminished the effectiveness of the response.

Keep reading

Even though the United States does not officially have “socialized” health care, a large proportion of our medical care is funded by the federal government. Even though I know that, I was still surprised by statistics in a recent article, which stated that  the federal government accounts for

  • 40% of healthcare  spending
  • $1.3 trillion /year

(stats from 2016)

Through 4 federal agencies

  • Department of Health and Human Services 
  • Department of Defense
  • Veterans Administration
  • Department  of Homeland Security

(JAMA (Journal of the American Medical Association), June 21, 2016)

The  United States Congress passed the Patient Protection and Affordable Care Act (ACA) in 2010 to guarantee basic health insurance to all citizens.  People who oppose the ACA ,aka Obama Care, dislike or even fear government involvement in medical care; they consider it interference, control, or even nationalization of the United States healthcare system.

a Veterans Administration clinic
a Veterans Administration clinic (photo by Dr. Aletha)

I think many people, even physicians, don’t realize or forget, how involved the government already is in healthcare. As far back as the American Revolution the fledgling government extended health care benefits to the soldiers and veterans of that war; that system evolved into the current military health care system which covers service members and the Veterans’ Administration system for veterans.

American soldiers serving in Afghanistan
American soldiers serving in Afghanistan

2015 marked the 50th anniversary of two other government healthcare programs- Medicare and Medicaid.

Medicaid provides insurance coverage for adults and children who are unemployed or low income.

Medicare covers disabled children and adults  and persons 65 years and older.

wheelchair-749985_1280
Disabled children and adults may qualify for Medicare.

The numbers are rather staggering.

  • Together these programs cover at least 30% of Americans.
  • Together they comprise 25% of all federal spending.
  • Together they pay 40% of total U.S. health care spending.

An infographic from the Kaiser Family Foundation and JAMA explains this further.

hospital-79605_1280
Children may be eligible for Medicaid if their families cannot obtain health insurance for them.

You may not be eligible for either of these programs now, but chances are eventually you or someone close to you will.

  • Anyone can become disabled from a serious illness or freak accident.
  • You or your spouse may lose your job and your employer sponsored health insurance.
  • Your child may have a disability that will prevent them from working when they grow up.
  • We may all live long enough to qualify for Medicare on the basis of age alone.  Your parents or grandparents are near or already at Medicare age.
Senior adults age 65 and older use Medicare.
Senior adults age 65 and older use Medicare.

It’s important to understand how Medicare works, since it’s not automatic; even if you qualify, you need to sign up to be covered (with a few exceptions). The rules are summarized here. Or consider an easy to understand book here. 

Several government agencies regulate, monitor, promote and/or support  both public and private healthcare through the Deparment of Health and Human Services and other agencies.

Food and Drug Administration- FDA
Centers for Disease Control and Prevention- CDC
National Institutes of Health- NIH
President Joe Biden visited the NIH
Occupational Safety and Health administration-OSHA
Drug Enforcement Agency-DEA

Congressional laws that regulate health care

 The Affordable Care Act- ACA
Health Insurance Portability and Accountability Act-HIPPA
Emergency Medical Treatment and Labor Act- EMTALA
Health Information Technology  for Economic and Clinical Health- HITECH
Americans with Disabilities Act-ADA
Family Medical Leave Act-FMLA
LIFE, LIBERTY AND THE PURSUIT OF HEALTHCARE

Sharing the HEART of health

In the Declaration of Independence, the founders of the United States created a nation based on the “self-evident truths”  of  “Life ,Liberty, and the pursuit of Happiness” as well as to promote “Safety and Happiness” . 

In the Constitution they vowed to “promote the general Welfare”.

I wonder if they envisioned that government would eventually spend so much timet and money providing and regulating health care, most of which was not imagined at that time? 

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Dr. Aletha

Key Predictions about 2026 Health Policy from an Expert

In this post I review some 2026 healthcare predictions for likely continuation of partisan gridlock, minimal congressional action, and increased focus on health care affordability amid midterm elections. Key issues to watch include ACA enrollment responses, Medicaid work requirements, rising insurance costs, and the impact of AI on consumer health care navigation.